SearchOklahoma225200000X

Jeremy Tackett, PTA

NPI 1043412364 · on the registry since 2007 · sole proprietor

Practice

Address
1013 W Park Ave
Checotah, OK 74426
Phone
(918) 473-1748
Fax
(918) 473-1748

Registry record

Primary taxonomy
225200000X
225200000X
Licence states on file
OK
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma